The “Nordic workshop on joint strategies for per- and polyfluorinated alkyl substances (PFASs)” was hosted by the Swedish Chemicals Agency in Stockholm, Sweden on 5-6 April, 2017.The aim of the workshop was to gather scientific and regulatory experts, identify common issues related to PFASs, recommend priorities and steps/strategies forwards and facilitate continued information exchange and cooperation. Participants consisted primarily of Nordic delegates but also representatives from other regions and arenas e.g. the European Commission, the EEA, the ECHA PFAS network.Conclusions discussed at the workshop can be considered as being supported by the several Nordic agencies and non-Nordic agencies.The outcomes of the workshop are detailed in this short communication and concern both general and specific considerations

Find inspirationin the Nordic cities

This booklet showcases the Nordic Sustainable Cities – giving you an insight into the shared practices that Nordic cities are using towards sustainable urban futures. The challenges that Nordic cities face – unsustainable resource consumption, pollution, homelessness, segregation, to name a few – are not unique to the region, but found all over the world.

The Nordic region and its cities are on a journey towards sustainability, and we invite you to join us.

This booklet is based on the White Paper on Nordic Sustainable Cities made by Nordregio. The booklet and the white paper has been made as part of the Nordic Sustainable Cities project. Nordic Sustainable Cities is one of six flagship projects under the Nordic prime ministers’ initiative Nordic Solutions to Global Challenges, which is coordinated by the Nordic Council of Ministers.

The purpose of this study was to estimate the preliminary prevalence of multiple sclerosis (MS) in the County of Värmland, with prevalence date 21 December 2002, and to compare this with other prevalence studies in Sweden. The clinical data of the patients were collected from medical files at the medical care facilities in the county. For classification of MS the criteria by Poser were used. The diagnoses were scrutinised by neurologists. Based on the collected data, August 2004 the prevalence of definite/probable MS in Värmland is 151/105 (95% CI 136-165), for women 211/105 (95% CI 187-235), for men 89/105 (95% CI 73-105), resulting in a female to male ratio of 2,37. When comparing these results with prevalence numbers from Västerbotten County in the north of Sweden and Gothenburg respectively, our prevalence number reaches the level of that from Västerbotten, indicating that Värmland, as well as Västerbotten, is a high risk zone for MS.

Norwegian Board of Health controls that the municipal authorities in Norway fulfil their legal obligations as regards the municipal health service. Since 1995 system auditing has been the main method of supervision. In addition to Norwegian Board of Health in the Counties controlling that the legal obligations of the municipalities are upheld, system audits are meant to encourage systematic improvement efforts in the municipal health services. The aim of this essay has been to describe how the system audits affect improvement efforts. This is a qualitative study conducted as a case study in two Norwegian counties. Data collection was done during the autumn of 2001, by studying documents and in four focus groups – two in each county. The main focus was on what expectations 28 employees (14 leaders and 14 professionals) in 19 different municipalities had to the system audits, how the results were handled in the municipalities, and how useful the employees felt that the auditing had been. The results show that the system audits lead to greater activity in processes in the municipalities. The audits upset some and pleased others. The main differences were between a wish for more aid regarding professional improvements of the health service and a desire for greater municipal autonomy. Three areas of the audits were shown to be important for encouraging systematic improvement efforts in the municipal service: language/communication, individual adjustments, and that the municipality top management was directly involved during the audits.

To some degree, metropolitan regions owe their existence to the ability to valorize agglomeration economies. The general perception is that agglomeration economies increase with city size, which is why economists tend to propagate urbanization, in this case in the form of metropolization. Contrarily, spatial planners traditionally emphasize the negative consequences of urban growth in terms of liveability, environmental quality, and congestion. Polycentric development models have been proposed as a specific form of metropolization that allow for both agglomeration economies and higher levels of liveability and sustainability. This paper addresses the challenge of how such polycentric development can be achieved in planning practice. We introduce ‘agglomeration potential maps’ that visualize potential locations in a polycentric metropolitan area where positive agglomeration externalities can be optimized. These maps are utilized in the process of developing a new spatial vision for Flanders’ polycentric ‘metropolitan core area’, commonly known as the Flemish Diamond. The spatial vision aspires to determine where predicted future population growth in the metropolitan core area could best be located, while both optimizing positive agglomeration externalities and maintaining its small-scale morphological character. Based on a literature review of optimum urban-size thresholds and our agglomeration potential maps, we document how such maps contributed to developing this spatial vision for the Flemish metropolitan core area.

This brochure highlights the work conducted by the Joint Nordic screening group. The activities in the Joint Nordic Screening Group can be divided into three areas: 1) Joint screening studies, 2) Sharing knowledge by organizing seminars and 3) literature studies.

The aim of the joint Nordic screening studies is to obtain a snapshot of the occurrence of emerging pollutants in the environment. A Nordic cooperation on screening studies is an advantage for increased representativity of the results since it is possible to include a larger number of samples in a larger area than normally in national studies. In addition, it is cost effective and makes it easy to compare results with neighbouring countries.

The group has its own webpage, from where the reports can be downloaded.

The Working Group on Environment and Economy of the Nordic Council of Ministers publishes regular reports on the use of economic instruments in Nordic environmental policy. This report is part of that series and has two parts. Part 1 presents an overview of the use of economic instruments in Nordic environmental policy, with a focus on policy changes over the period 2010-2013. Part 2 develops a framework for assessing the political possibilities of reforming environmentally harmful subsidies, and applies this framework to three cases relevant in the Nordic context. The report was prepared by Copenhagen Economics, GreenStream Network and Environice. The authors of the report are Hrafnhildur Bragadóttir, Carl von Utfall Danielsson, Roland Magnusson, Sampo Seppänen, Amanda Stefansdotter and David Sundén.

The purpose of the report is to clarify the legal possibilities of restricting export of certain types of used EEE due to e.g. content of hazardous substances, energy consumption and/or limited market value.

The focus is current environmental regulation and trade regulation which have been evaluated in order to identify if they can serve as the legal basis for setting restrictions on export.

The analysis concentrates on the legal framework of trade within the rules of the internal market in the EU and the legal concept of the WTO that regulates trade between countries worldwide.

The report concludes that waste regulation has very limited possibilities in regards to restricting export of used EEE. In regards to trade restrictions, it cannot be ruled out that such restrictions can be adopted in accordance with the rules of the internal market in the EU and the legal concept of WTO.

The 1999 Gothenburg Protocol to Abate Acidification, Eutrophication and Ground-level Ozone, with focus on emissions of NOX, SOX, NH3, and VOC, is the latest protocol under UNECE's Convention on Long-range Transboundary Air Pollution. This report offers a Nordic perspective on implementation of the protocol in terms of the measures that have been introduced in the Nordic countries, the effects of these measures as well as how the reductions agreed under the protocol may be attained.

We point out two reasons why policy-makers may consider redesigning social insurance systems in the light of increasing migration flows. First, immigrant labour supply is particularly sensitive to social insurance parameters. Second, employers and migrants may benefit from the creation of low-paying jobs, which means that generous benefits may affect both the level of immigration and its composition. Still, we do not recommend a reduction in the level of benefits or the imposition of tighter regulations on migration. Instead, we call for a more activity-oriented social insurance policy. The policy brief is produced by Nordregio on behalf of the Nordic Welfare Centre and the project Nordic collaboration for integration. More information at www.integrationnorden.org

What can we learn from each other and others? Since the mid-eighties the Nordic countries have received a high influx of refugees relative to the population size. Currently these countries receive large numbers of refugees, notably from the Middle East. Existing studies exploiting the rich administrative registers in the Nordic countries have shown that the speed of labour market assimilation of immigrants from non-Western countries in the Nordic welfare states is slow. However, few studies distinguish between refugees and non-refugee immigrants from Non-Western countries.

In comparison is the commonly used Cap and Trade method with an alternative and novel method for pricing pollution: The aim was to conduct a practical approach to clarify advantages and challenges of the respective mechanisms. Shortly, the report promotes:

1) Levying a Fee which is sufficiently high and adjusted sufficiently often for a Fee.

2) Letting the Futures Market and other hedging and insurance instruments indicate the price (the average abatement cost) which can be levied without harming the economy.

3) Securing a repayment of a sufficiently large fraction of the revenue from the Fee.

These three parts or components are all essential to the mechanism. Still, key questions remain unanswered in this report. This project was launched by the Working Group for SCP (HKP) in collaboration with the Working Group on Environment and Economy (MEG) under the Nordic Council of Ministers.

This report explores how public sector support promotes the locomotive model, which is understood as partnerships between locomotive companies and SMEs in order to facilitate export of cleantech and system solutions. Support structures vary a lot among the Nordic countries. A main observation is that the various programmes in all Nordic countries had little information on the impacts of the instruments. Some suggestions for policy makers in the Nordic countries are offered, now with an understanding of the interaction between large businesses and SMEs, which wish to export clean technologies. The project was carried out from May 2014 to December 2014 by a consortium led by COWI with FORES, Swedish Entrepreneurship Forum and Tyrsky Consulting as partners. The Nordic Council of Minister's Working Group on Sustainable Consumption and Production initiated and financed the project.

Underpricing of fossil fuels, caused by subsidies, drives carbon intensive consumption. Reforming fossil fuel subsidies and allocating some of the savings to sustainable energy could accelerate a transition to fairer, safer, cleaner and more sustainable energy systems. This report outlines the Nordic Council of Ministers’ work to promote these swaps through the development of a business model and description of the link between fossil fuel subsidies, reforms and carbon emissions. The report evaluates potential swaps to increase industrial energy efficiency in the mining sector, in the context of energy sector reforms in Zambia; and the replacement of butane subsidies with solar investments in Morocco. The report also presents an outline of how Nordic countries are supporting reforms and driving the swaps agenda as part of Nordic Solutions to Global Challenges.

This report examines the relationship in the Nordic region between the well-being of young people and their consumption of social media. Is the growing use of social media by young people a problem for their personal well-being and their participation in non-digital communities in society? The main conclusion is that we cannot judge the consumption of social media as something unequivocally positive or negative for the well-being of young people, without relating to a number of specific conditions, which significantly nuances the picture. We must relate to who uses the social media, which media they use and how long time they spend. We must also relate to how social media is used. When we take into account the above-mentioned conditions, we find a number of effects from young people's consumption of social media, which you can read about in the report.

Method: We used a qualitative research method and content analysis to examinedata collected from semi-structured interviews Ten participants (5 malesand 5 females) who worked as senior managers, middle-management executives in the healthcare service, and Ministry of Welfare officials. The participants reflected a breadth of experience and education across the spectrum of age, length of service, and work experience in both hospitals and primary care.

Results: Data analysis revealed three main categories including policy-making plans in healthcare, which identified a considerable gap between managers and executives on one side and the Ministry of Welfareon the other, especially regarding strategy. Incidental control and effect of politicians on healthcare operation. Second, inrelation to the Ministry of Welfareand healthcare institutions we observed unstructured, onerous, and remote communications and organization that focused too little on professional issues. The Ministry of Welfare tended to interfere with managers’ responsibilities and scope of work. Third, we observeds trengths and weaknesses in management. Strengths includedad ministrators’ enthusiasm, ideas of empowerment, short lines of communications, and often straightfor ward interactions, compared withweaknesses in the workprocesses within healthcare institutions and toward the Ministryo f Welfare, and also in job descriptions and vague definitions of the institutions’role.

Conclusion: The indications reported here suggestun clear policy-making plansfor healthcare institutions. Although managers and executives maintained that visions for the futureare vague, the Ministry of Welfare stated that the strategy was clear. The study identified a need of strengthening and restructuring the way of communications, as well as clarifying managers’ role toward the Ministry of Welfare

Purpose: to assess the effectiveness of the Norwegian adolescent BCG vaccinationprogramme by (1)examining if differences in tuberculosis epidemiology in four Nordiccountries is associated with different use of BCG and (2) using evidence from this and paststudies on BCG efficacy to estimate the impact of vaccination in the present epidemiologicalsituation.

Method: The study period was 1975-2005, with main focus on 1996-2005. Data sourceswere articles, surveillance reports, the EuroTB database, and national tuberculosis registers.EuroTB data were used to calculate incidence rates for cases reported as “born incountry/national” in Norway, Sweden, Finland and Denmark. Data from the Norwegian andSwedish tuberculosis registers were used to calculate incidence rates for cases that were born in the respective countries and that had parents who were both born in countries with low incidence of tuberculosis. Incidence rates in the age groups 0-14 and 15-29 years were compared.

Main results: From 1975 to 2005 all countries experienced a reduction in incidence rates,most pronounced in Finland. During 1996-2005 Finland had the lowest incidence rate in the0-14 year age group, and Norway had the lowest incidence rate in the 15-29 year group. Thisis consistent with protection by BCG vaccination of newborns in Finland and of 12-14 yearolds in Norway. We estimated that the Norwegian adolescents BCG vaccination programme confers 61-64% protection in the age group 15-29 years. Assuming 50-80% protection, 14918 - 51 409 vaccinations are needed to prevent one case of tuberculosis. During 1996-2005,prior BCG vaccination of Norwegian teenagers may have prevented 1.2 - 3.9% of cases oftuberculosis among Norwegian-born and 0.4 - 1.2% of total cases.

Conclusions: BCG vaccination of low-risk Norwegian adolescents may have contributed to reduced risk of tuberculosis for a period of 15 years after vaccination. However, a large number of vaccinations must be given in order to prevent one case of tuberculosis.

This book, an introduction to some of the current trends that are affecting spatial development, came about as a result of a course offered by Nordregio. It is intended as a companion to similar courses in the future, but more as an introduction to themes that often are less than accessible to busy, but interested, practitioners.

Since 1949, Tibetans and Uyghurs generally have been perceived as the two most problematic members of the PRC’s great family of peoples and been the targets of ‘carrot and stick’ measures designed to facilitate their integration into the PRC. In recent years, a solution to the problem of Xinjiang and the Tibet has been sought in accelerated economic development, yet this is perceived by both groups with great suspicion. Addressing this situation, the volume explores the arenas of socio-economic development and market liberalization, popular culture, urban planning and relocation, environment and ecological migration, civil society, education and language, ethno-nationalism, as well as religious policies and practices. It is especially topical at a time when fieldwork in the regions where these two minorities live remains extremely difficult and politically sensitive.

The aim of this study was to gain more insight about the users of day-care centres for the elderly and how their every-day lives benefited from having access to this service. For the purpose of this study, in-depth interviews with nine users were conducted. The principle of Grounded Theory was used in the data collection and analyses. One of the core categories that emerged was: The feeling of social deprivation and depression is amended through activities and social contact with other senior citizens. The results showed that loneliness and isolation were widespread among the participants. Having access to the day-care service two-three times a week provided them with a social network and social activities. This, in turn, made them feel more comfortable and in better general health. The most important findings were that the day-care centre represented a sense of community with other senior citizens, activity, a sense of well-being, and care

When victims of trafficking are identified in a country of destination, they are often in a situation marked by lack of clarity. In response to this, most European countries have a so-called reflection period for victims of trafficking, typically lasting from 30 days to six months, during which the victim cannot be sent out of the country, and where he or she can reflect upon the above issues and receive assistance. The intention of the reflection period is to help protect victims, but also to prosecute traffickers. How can these two – sometimes conflicting – goals best be met? This report discusses implications of the models in the Nordic countries, Belgium and Italy.

For well over a century, Chinese fengshui - or 'geomancy' - has interested Western laymen and scholars. Today, hundreds of popular manuals claim to use its principles in their advice on how people can increase their wealth, happiness, longevity, etc. This study is quite different, approaching fengshui from an academic angle. The focus is on fengshui's significance in China, but the recent history of its reinterpretation in the West is also depicted.

The author argues that fengshui serves as an alternative tradition of cosmological knowledge, which is used to explain a range of everyday occurrences in rural areas such as disease, mental disorders, accidents and common mischief. Although Chinese authorities have opposed the tradition for centuries, nonetheless it has been used by almost everyone as an aspect of popular cosmology. Opposing the Chinese collectivist ethos and moralizing from above, fengshui represents an alternative vision of reality, while interpreting essential Chinese values in a way that sanctions selfish motivations and behaviour.

The study includes a historical account of fengshui over the last 150 years augmented by the results of anthropological fieldwork on contemporary practices in two Chinese rural areas. Aiming to eschew Western intellectual preconceptions and to penetrate the confused mass of old texts and divergent local practices, the book will be of interest to all scholars seeking to understand an undercurrent of modern China's transformation.

The Nordic Council of Ministers has a long tradition for highlighting solutions to theenvironmental challenges in their working groups, research programs and publications.This reports aim to summarize some of the recent work on greater resource efficiencyand greener economic growth and development in the Nordic countries, including corebackground documents from the Nordic Council of Ministers, The Nordic primeministers’ Working Group for Green Growth, and the EU, research studies related togreen growth financed by the Nordic Council of Ministers and the Oslo conference onGreen economic growth held in March 2012. The report was commissioned by theNordic Council of Ministers, with Øyvind Lone, chair of its Working Group onEnvironment and Economy, as contact person.

The report reviews the different initiatives aiming to measure aspects of “green” sectors, jobs and technologies. The report discusses whether the statistics collected under the present initiatives aimed at measuring these aspects increase insights into the fundamental questions motivating the initiatives. An alternative framework is suggested, as it appears fundamentally impossible to make consistent frameworks for a division of the economy into “green” and “non-green” activities. The analysis has been carried out during the period September 2011 – March 2012 by Vista Analysis AS, Gaia Consulting Oy and University of Aarhus. Gaia Consulting Oy is responsible for the chapters 5.2., 5.3, 6.2, 6.3 and 7.2 only. The project was commissioned by the Working Group on Environment and Economy under the Nordic Council of Ministers.

Reforming environmentally harmful subsidies: How to counteract distributional impacts The report discusses the theoretical principles for an efficient environmental and distribution policy and offers a comprehensive survey of experiences from policy reforms in different countries. The reform survey forms a background to recommendations for implementation of sustainable policy reforms, taking care of environmental, economic and distributional concerns. It particularly brings in the Nordic experiences, both to enlighten the problems with environmentally harmful subsidies in these countries, and to discuss what can be learned from the experiences in a broader international context. The analysis has been carried out during the period October 2010 – May 2011. The study was carried out by Vista Analyse AS and commissioned by the Nordic Council of Ministers for the Environment.

This project adds insight into the potential contribution to fiscal consolidation from environmental tax and subsidy reforms, i.e. strengthening public budgets while at the same time improving economic efficiency and the environment. The report contributes with own calculations for potential revenues from environmental taxes and discusses the financial crisis and environmental tax policy responses in Iceland, Estonia and Ireland as case studies.The analysis has been carried out during the period July 2012 – December 2012 by Vista Analysis AS, Norway, Reykjavik University, Iceland and PRAXIS Center for Policy Studies, Estonia. The project was commissioned by the Nordic Council of Ministers.

The Nordic Council of Ministers (NCM) considers initiating a project with the purpose to identify the driving forces behind the development of Nordic emissions to air. Two approaches are under consideration: a backward-looking and a forward-looking. The backward-looking approach aims to identify the reasons for the growth of emissions over the past decades. This analysis requires detailed statistical information on emissions from firms and households in (at least) two observation years covering the period of interest: preferably the most recent year available, and a historical year some 10-20 years before. The forward-looking approach would exploit a simulated data set. In addition to a year representing today, the remaining observation year(s) would be in the medium- or long-term future (20-50 years ahead). Simulation of data for the Nordic countries would be based on economic models. This pre-study assesses the possibilities to conduct backward-looking and forward-looking decomposition analyses for the Nordic countries, Norway, Sweden, Denmark, and Iceland.

The aim of this study is to understand the experience and knowledge of intersectoral collaboration of the participants in the health promotional project “Feel good in the old age”. The study focuses on successful factors and barriers in the collaboration process, how the project have affected the power between the non governmental and the public organisations, the participants organisational experiences of collaboration, their view of the working climate in the project and their experiences of SOC in the project. Research in intersectoral collaboration in health promotion among elderly is sparse. The methodology is a qualitative study with focus groups. 11 focus groups was made with 62 participants from the different organisations – non governmental and public- and old and people becoming elderly. The project leader wrote the answers before the focus groups were made. Content analysis was used. As successful factors nine themes appeared: 1. leaders, energizers, duration, listen, 2. the public organisations are the most important but all are valuable, 3.people met and created a process with flow, 4. participation, 5. working over boundaries is a new way of working, 6. people and organisations learned from each other, 7. building of networks increased in the society, 8. sense of coherence and 9. positive working climate and no stress. Nine themes appeared in the analysis of barriers (elderly and becoming elderly was grasping five of them and the project leader seven): 1. insufficient support and legitimacy, 2. insufficient resources and use of available resources, 3. insufficient organisational conditions, 4. unequal power and economical conditions, 5. insufficient anchoring, 6. preservations and competition, 7. insufficient participation and trust, 8. insufficient methods and 9. the work in the project was under stress. The participants experienced participation in the project. Both public and nongovernmental representatives did not think the project had influenced the public organisations. The legitimacy of the project decreased during the run. The participants got new knowledge in how to work in collaboration, new competence of how to work over the boundaries and of the importance of building relationships and networks. The working climate was seen as healthy and as with stress. The SOC 13 formula was used to measure the participant’s sense of coherence in the project. The score was relatively high. The study shows difficulties in intersectoral collaboration. There are some signs that the public sector is not yet ready to change the paradigm. There are though a lot to win to initiate health promotion. A social fellowship develops in a democracy process with empowerment as the method, farthest out to reach a sustainable development

This report summarises the knowledge on plastics in Nordic marine species. Nordic biota interacts with plastic pollution, through entanglement and ingestion. Ingestion has been found in many seabirds and also in stranded mammals. Ingestion of plastics has been documented in 14 fish species, which many of them are of ecology and commercially importance. Microplastics have also been found in blue mussels and preliminary studies found synthetic fibres in marine worms. Comparability between and within studies of plastic ingestion by biota from the Nordic environment and other regions are difficult as there are: few studies and different methods are used. It is important that research is directed towards the knowledge gaps highlighted in this report, to get a better understanding on plastic ingestion and impact on biota from the Nordic marine environment.

Aims: This study sought to explore the knowledge Norwegian patients with ankylosing spondylitishave about the disease and to what extent belief in their own capacity to master the disease affectshealth-related quality of life.

Methods: We used questionnaires to explore and describe participants’ knowledge about ankylosingspondylitis. The questionnaires also assessed how this knowledge affected participants’ lifesituations. The study included 150 patients who participated in a rehabilitation programme abroad.

Results: The patients were most satisfied with information provided by rheumatologists and physiotherapists. They also considered fellow patients as an important source of information. Less satisfactory was information provided by nurses and courses in disease mastery. Respondents werevery knowledgeable about disease symptoms and physical exercise. However, they described their knowledge about medication and appliances designed for use at home or in the workplace as limited.The patients who were most satisfied with their knowledge about the disease had a significantly better belief in their ability to cope with pain and disease-related symptoms.

Conclusions: Knowledge about their disease contributed positively to patients’ health-related quality of life. Sharing knowledge and personal experience with others who are in similar situations enhances learning and appears to be a useful and positive way of providing patient education.However, adapting training to the educational background of participants will require careful assessment of the target group. Similarly, the roles and domains of health care professionals require clear definition.

The EU’s Directive 2012/27/EU on energy efficiency obliges Member States to develop programmes to encourage small and medium sized enterprises (SMEs) to improve energy efficiency by implementing energy audits and the recommendations that stem from these audits. This study looks at the barriers that SMEs face and the existing policy instruments in more detail and analyses which practices are working. The study concludes that SMEs cannot be effectively targeted with solely uniform solutions even within the same country and even though many of them face similar barriers. More emphasis is needed on sharing information and best practices and guiding SMEs to implement energy efficiency improvements after having identified the opportunities. The good news is that many good practices already exist and there is potential to improve. Now it is just a question of taking action.

Aim: This study aimed to valuate the opinions of healthpersonnel involved in the care of children on the introduction of various new and older vaccines to the Swedish childhood vaccination. We particularly examined the knowledge of varicella diseaseas chickenpox and shingles and attitudes toward the varicellavaccine.

Method: We created and administered aquestionnaire on vaccineprioritization forseveral vaccines, including hepatitis A and B,BCG(BacilleCalmette-Guérin) vaccine to preventtuberculosis, pneumococcal, meningococcal, HPV (human papilloma virus), rotavirus, influenza,respiratory syncytial virus,andTBE(tick bornencephalitis virus),and also explored health personnel’s knowledge about the VZV (varicella zoster virus) vaccine and its diseases. In 2006, the study targeted 600 nurses and physicians in Gothenburg, Sweden, whereas the current study in 2012 followed up with 160 school healthcare personnel.

Results: The 2006 questionnaire generated 191/600 responses (32%), compared withthe 2012 follow-up questionnaire, which generated 40/160 (25%) responses from school health care personnel. Medical personnel ranked vaccination against hepatitis B highestin both studies. However, our data showed an important shift in attitude regarding HPV and rotavirus vaccination, which ranked lowestin 2006 but higher priority in 2012. Respondents also gave high priority to BCG. In 2006,only 34 of 138 respondents (25%) knew that a varicella vaccine was available, and universal varicella vaccination was generally ranked lower compared with other various vaccines. Additionally, pediatricians and personnel from infectious diseases department in the hospital having direct experience with these verity of varicella and zoster diseases were more likely to support universal varicella vaccination. Interestingly, in 2012 only one third of school healthcarepersonnel favored universal varicella vaccination.The health professionals xpressed a general demand for information and in-depth nowledge about the newer vaccines.

Conclusion: If Swedish authorities decide to implement universal varicella vaccine into the current successful vaccination program for children, relevant healthcare personnel will require further education about VZV vaccineand disease

This is the first comprehensive study to analyse in detail the evolving political, economic and diplomatic relationship between China and Denmark since their first contact in 1674. The book is thoroughly researched and based on newly available source material in Chinese as well as in Western languages. It is an important contribution to the growing literature on China’s relations with the West since the beginning of the modern period.

Is it posible linking biodiversity to macro economic models, thereby increasing our understanding of how economic activities affect biodiversity – et vice versa? It is the key question that this report aims at answering on the basis of existing statistics, indicators and models in the Scandinavian countries.

This first-ever catalogue in English of the Danish National Library's rich Sanskrit holdings analyses and describes three of the manuscript collections held by the library.

The first is the Codices Sanscriti, collected in the early nineteenth century by the pioneer comparative linguist, Rasmus Rask, comprises both palm-leaf and paper manuscripts, most written in either Bengali, Telugu or Sinhalese script.

The second - the Codices Indici - was collected by the surgeon and botanist, Nathanael Wallich (well-known for his involvement in the foundation of the Indian Museum and Botanical Garden atCalcutta). Mostly written in Bengali script on locally produced country paper, most of these codices pertain to the genre of Ayurveda.

The third and largest collection originates from Nepal and was collected in the 1950s by the cultural anthropologist Werner Jacobsen. Its highly heterogenous nature reflects the fact that Jacobsen had an ethnographical curator's eye for curious objects.

Together these comprise a rich offering to philologists, anthropologists and historians of religion, art and iconography.

The textile industry is one of the world's largest industries. The fashion and textile industry is also one of the most polluting and resource-consuming industries in the world. Ecolabels such as the Nordic Swan Ecolabel and the EU Ecolabel can play an important role in reducing the environmental impact of textiles purchased in Nordic countries. The project aims to identify barriers to more ecolabelled textiles on the Nordic consumer market and initiate activities and actions to remedy these. The project has also taken a global perspective, identifying how producers in e.g. India and Turkey can be encouraged to engage in eco-labelling. The study was financed by the Nordic Council of Ministers and carried out by Nordic Ecolabelling with a subgroup of the Nordic Sustainable Consumption and Production group (HKP) as steering group

This report presents results from the NovasArc project that has collated data on the distribution of vulnerable marine ecosystems (VMEs) in Arctic and sub-Arctic waters. Eleven VMEs were identified, based on management goals for coral and sponge communities. Many of the vulnerable marine ecosystems (VMEs) in the study area has a wide distribution. Soft and hard bottom sponge aggregations, hard bottom gorgonians, sublittoral sea pen communities, and cauliflower corals are predicted to cover > 20% of the study area shallower than 1000 meters.

Of the anthropogenic activities in the study area bottom trawling represents the main threat to the VMEs. The compilation of trawling activity in the study area shows that fisheries mainly occurs shallower than 1000 meters and that 50 to 60% of the seafloor is not targeted. However, 30% of the seafloor has experienced intermediate to very high fishing effort.

In general, the VMEs shows a larger overlap with fishing when the risk analysis is based on areas with an optimal habitat suitability. Using this conservative threshold to model the distribution of VMEs the results indicate that most VMEs have experienced an intermediate to high level of fishing in less than 40% of their distribution area in the whole study area.

This study aimed to assess how parents of children with spastic Cerebral Palsy (CP) evaluated the efficacy of Botulinum Toxin A (BTX) treatment on their child.

Method: Triangulation of measurement processes, i.e., qualitative assessment including two focus group interviews with experts and three interviews with parents; quantitative assessment involving questionnaires send to parents of 47 children treated with BTX at Hilleroed Hospital. The qualitative data were analysed using content analysis.

Results: Focus group interviews indicated that questionnaires should seek detailed information about the daily activities of children undergoing BTX treatment, beginning treatment initiation and continuing until BTX effect declined. Parent interviews showed that two out of three would allow another BTX injection; waiting time on treatment day was too long; and hospital routines should be optimized to meet the needs of disabled children. Forty-one parents (12 fathers and 29 mothers) completed the questionnaire. The study included 30 children receiving BTX between 2004 and 2007. Parents described the best effect of BTX as reduced spasticity. Walking ability improved in 67% of children who could walk before treatment, and improved motor skills provided new ways of moving. Twenty-two parents believed that BTX treatment fulfilled doctors’ expectations. Maximum BTX effect occurred after three to six months. Effects differed with each treatment, mostly on a declining scale. Parents felt very welcome in the children’s ward and also felt that the staff listened to them; their overall assessment of treatment day experience was good. Major concerns included waiting time and a missing meal following treatment. Views of healthcare services for children with CP did not differ between fathers and mothers. The study indicates that development of national guidelines for BTX treatment will be highly recommended.

Conclusion: The majority of parents agreed to repeat BTX injections, mainly because outcome was positive or met their expectations. A minority would refuse future BTX treatment, primarily due to lack of effect or because of significant problems for small benefit. Optimizing hospital routines on treatment day would help disabled children navigate BTX treatment more successfully

The contributions in this book all address an important area relating to the delivery of medical services, namely the development of consumer medicine. The changing dynamics of consumer medicine are explored through two perspectives: genetic self-testing and cross-border medical treatment. Both genetic self-testing and cross-border medical treatment offer a number of opportunities, both for producers and consumers of goods and services. At the same time, however, a number of important questions arise as to the limits and regulations that should be in place to protect consumers and patients, and assure that the products and services that are being offered are of good quality and do not offer false or misleading information as to their efficacy or significance in helping patients and consumers. The role of the state and supra-national organizations is by no means self-evident within this changing environment in that on the one hand, this process has been supported by these same authorities, and on the other hand, they are also trying to control and limit the extent to which it develops and undermines their sovereignty. This dual role has created tensions between the development of consumer medicine and the consequences that authorities must deal with as a result of this development.

This comparative report is the sixth report, complementing the five country reports (Nordregio working papers) of the research project "Coping Strategies and Regional Policies, Social Capital in Nordic Peripheries". The research includes fieldwork during 2001 in Greenland, Iceland, the Faroe Islands, Sweden and Finland, two localities per country, two projects per locality. The project was co-operatively conducted by researchers from the University of Iceland (Reykjavik), the Research Centre on Local and Regional Development (Klaksvík, Faroes), the Swedish Agricultural University (Uppsala), the University of Joensuu (Finland) and Roskilde University (Denmark).